Active NPI
Laikawn Wilder
- Peer Specialist
- Portsmouth, OH
National Provider Identifier
1730008392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- PRS.008150
- Practice address
- 411 Court St
Portsmouth, OH 45662-3932 - Phone
- (740) 354-6685
- Fax
- (740) 876-4005
- NPI assigned
- Jul 15, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | PRS.008150 | OH | Primary |
Addresses
Primary practice location
411 Court St
Portsmouth, OH 45662-3932
Mailing address
411 Court St
Portsmouth, OH 45662-3932
Phone (740) 354-6685
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1730008392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 COURT ST",
"city": "PORTSMOUTH",
"state": "OH",
"postal_code": "456623932",
"telephone_number": "740-354-6685",
"fax_number": "740-876-4005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 COURT ST",
"city": "PORTSMOUTH",
"state": "OH",
"postal_code": "456623932",
"telephone_number": "740-354-6685",
"fax_number": "740-876-4005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDER",
"first_name": "LAIKAWN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-07-15",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": "PRS.008150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.